Archive for June 16th, 2010

By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Wellness Coach, ACSM Personal Trainer

As a massage therapist and personal trainer, I am NOT a doctor. According to the State of Illinois, I have no medical credentials beyond licensure for massage therapy. However, I see my clients more often than many of them see their doctors. I see more of my client’s skin than they can see themselves (especially their backs).  I  palpate my clients’ muscles and limbs when I massage them. Over the years I have run into several situations where I’ve noticed skin problems, suspicious bumps and lesions, odd body odors and general changes in my clients complexion and energy level that indicated disease. Some of my clients are serious athletes, others are desk jockeys with very little physical activity. All of my clients come to me with some issue, pain or injury and often they come to help handle stress.

Before I go on let me throw out a HUGE derriere-covering disclaimer: I don’t think that massage therapy is a substitute for medical care. I don’t think you should run to your massage therapist instead of to your doctor. What I do think is that massage therapists see your body, feel changes in your tissue and have a more intimate working knowledge of your body as it changes over time more so than the medical doctor you see maybe once per year.  Below I have listed some of the situations where massage therapists can be your first line of defense and awareness of health issues.
Skin Cancer
In massage school, we were taught to identify suspicious skin conditions and look for moles or freckles that fit the ABCD rule. (The ABCD rule helps identify potential areas of skin cancer: if a mole/freckle is asymmetrical, is bigger than a pencil eraser, is multicolored or dark black and is larger in diameter than a pencil eraser, it may be skin cancer.) I can’t treat or diagnose skin cancer, but I can tell my clients about a suspicious looking mole on his or her back. Melanoma is a serious form of skin cancer. If you have a mole or discoloration on your back or other hard to see area (back of knees for example), your massage therapist can notice your skin and changes in your skin each time you receive a massage.

Tension Headaches

Often times, tense neck and upper back muscles can lead to tension headaches. Some of my clients have chronic headaches and have been to doctors  and neurologists that find no known causes. If the pain in a client’s head is caused by tight muscles triggering the pain to their temples, a few minutes of massage can really help relieve their pain. And as a massage therapist, I know that I can’t “treat” a headache and I don’t pretend to be able to diagnose allergies or neurological conditions. I refer my clients to doctors that can do that. But when headache pain is just a general condition causes by muscle pain and my client has already ruled out any serious illness, relieving muscle tension can make my clients’ lives much easier.

Cysts and Tumors

One of the benefits of going to the same massage therapist regularly is that your massage therapist gets to know your body–and knows when something is not normal. I’ve had quite a few clients with  sebaceous cysts (usually benign pockets of fat encapsulated by a cyst). Massaging these cysts is painful and not advised. But when I first see or feel a new cyst, I’ve been able to advise my clients to seek medical attention. Usually the doctor tells them that just a fatty tumor and it’s not a big deal. But there have been times when a client has had a fatty tumor growing into a nerve or growing so fast it causes them pain and discomfort. Again, having a regular massage therapist that notices these changes can help you get to a doctor before the tumor grows too large. In cases where the tumor is not benign, I’ve been glad that I told my client about the cyst right away so he or she can seek medical attention. In one case, my client told me the doctor removed it immediately  and the tumor did turn out to be serious.

Repetitive Use Injuries

Frequently clients come to me with complaints of neck pain, shoulder pain and wrist pain. Many of my clients are heavy computer and smart phone users with little time to stretch or exercise. Again, I do not diagnose nor do I treat carpel tunnel syndrome. But I can loosen the tense muscles around my clients cervical spine, the muscles in their forearms and the scalene muscles in their necks. Often times the pain disappears in just a few massage sessions. As a personal trainer, I can also give my clients exercises and stretches to do to keep their upper bodies from getting too tense again.

Muscle Injuries

When clients injure themselves in accidents or during exercise, my first advise is to see the doctor, then RICE (Rest, Ice, Compression and Elevate the injured limb). I don’t massage acutely injured muscles, especially if there is any chance of the muscle being torn or of the limb being broken. I also don’t massage bruises which any well-trained massage therapists knows is a contraindicated condition for massage. But after my client has seen his/her doctor or chiropractor, or if the injury is a week old and the client is on the mend, a few sessions of massage can send fresh blood to the effected area and help speed the healing process of my client’ own body. Using a combination of therapeutic techniques I can also release some of the muscle tension in the injured area and help ease my client’s scar tissue adhesions.

Scar Tissue

While I was in massage school I over exercised and ended up with a pretty serious groin pull. And after visiting two medical doctors that could not find out what was wrong, and after an MRI and an X-ray that did not show the scare tissue area clearly, I recovered thanks to the help of my massage teacher and my Chinese Medicine Doctor. It turns out my injury was bad enough to cause me pain and restrict my movement but not show up on an X-ray or MRI. After a few scar tissue massages, I was walking easier and my pain subsided.

I am not one of those people who think alternative medicine is the only way nor do I refuse medical treatment. If I need surgery, antibiotics, or have any serious medical condition, I go to the doctor. Bet most of my issues these days are not medical. They don’t require radiation explosing X-rays, doctors visits, pharmaceutical drugs nor surgery. In my own daily life, muscle tension is likely my number one complaint. And for that, I prefer massage therapy to muscle relaxers!

Colds and Flues

When I am working on my clients I notice their energy level and body temperature. A few weeks ago one of my regular clients was very rundown and quiet. When I worked her neck and back she feel very warm. I asked her is she was coming down with something and she said she didn’t think so. But something felt off and I worked on her more lightly. A few days later I got an email that she indeed did have a bad cold.

When someone has a fever, it’s often the first sign of the body fighting off a virus or infection. But in the summer heat it’s hard to tell if you are warm or feverish. Massage is contraindicated for a fever because it takes energy away from your body and your body needs that energy to fight the illness. Similar to working out when you are sick or run down. it can put your body into a healing crisis aka make you really really sick really really fast! When  feel a client is warm or seems low energy I change my focus and work with lighter strokes. I try to give them more of a relaxation massage versus a deep tissue massage. I can’t cure their cold and I can’t even diagnose what’s wrong with them. But I can modify my massage to fit their condition that day and that can help make them feel better or at the very least less sick than if I worked their muscles very deep that day.


Sometimes people are reluctant to go to their doctor or a specialist. They think their problems will go away over time. They don’t want to take the time to get an MRI or leave work to see their doctor. In this case, your massage therapist can nudge you to see your doc and verify that indeed your condition does require medical attention. If I massage someone who has muscle pain and there is not a noticable improvement in 1 or 2 sessions, of if the condition worsens, I advise them to see a doctor. For muscle and bones issues, I refer them to chiropractors or orthopedic doctors. By referring my clients to other health care providers, I let them know that yes their condition does require a doctor’s care. I also give them a second opinion (aside form their own) that yes they need to take the time to take care of their problem. Sometimes people are looking for an outsider to give them permission to take care of themselves. As a licensed massage therapist, in many people’s eyes, I have more credibility than say,Jimmy the Bartender, when it comes to body issues like injured muscles. Again, I am not treating or diagnosing, but I do notice, bring awareness to my clients and refer them to various other health care providers depending on their problem.

Emotional Issues

Lastly, for some people, being touched and having their muscles massages brings up emotions or memories of past traumas. For people dealing with addictions like compulsive overeating or smoking addiction, getting a massage brings their awareness to their body and may even make them want to take better care of their bodies. In these cases, I can refer my clients to licensed psychologists or counselors to help them better cope with their issues.

Overall, I look at massage therapists as partners in wellness with medical doctors, chiropractors and physical therapists. We are not doctors, but we do see clients more frequently than other health care providers and we do care about our clients health and well being!

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